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“Hospital at home” care was generally as effective as routine hospital care for older adults

https://doi.org/10.1136/ebn.2.2.51

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    Shepperd S, Harwood D, Jenkinson C, et al. Randomised controlled trial comparing hospital at home care with inpatient hospital care. I: three month follow up of health outcomes.BMJ1998 Jun 13:316:1786–91.OpenUrlAbstract/FREE Full TextShepperd S, Harwood D, Gray A, et al.Randomised controlled trial comparing hospital at home care with inpatient hospital care. II: cost minimisation analysis.BMJ1998 Jun 13;316:1791–6OpenUrlAbstract/FREE Full Text

    Question Is “hospital at home” (HaH) care as effective and cost effective as inpatient hospital care for older adults?

    Design

    Randomised controlled trial (RCT) with 3 months follow up.

    Setting

    A district general hospital and its catchment area (102 general practitioners [GPs] in 26 practices) in Northampton, UK.

    Patients

    Adults who had hip replacements (n=86), knee replacements (n=86), hysterectomies (n=238), chronic obstructive airways disease (COPD) (n=32), or who were elderly medical patients (n=96). Exclusion criteria were age <60 years (except for women having a hysterectomy), hysterectomy for malignancies, and an unsuitable home situation.

    Intervention

    After randomisation, the HaH group had 37 patients with hip replacement, 47 with knee replacement, 114 with hysterectomy, 15 with COPD, and 50 who were elderly medical patients. The hospital group had 49 patients with hip replacement, 39 with knee replacement, 124 with hysterectomy, 17 with COPD, and 46 who were elderly medical patients. HaH care included nursing, physiotherapy, occupational therapy, pathology, speech therapy, and …

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    Footnotes

    • Sources of funding: R&D Programme NHS Executive Anglia and Oxford; National R&D Programme, Primary Secondary Care Interface; NHS Executive North Thames.

    • For correspondence: Sasha Shepperd, Division of Public Health and Primary Health Care, University of Oxford, Institute of Health Sciences, Headington, Oxford OX3 7LF, UK. Fax +44 (0)171 706 8426.